RT Journal Article
SR Electronic
T1 Viruses causing lower respiratory symptoms in young children: findings from the ORChID birth cohort
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 969
OP 979
DO 10.1136/thoraxjnl-2017-210233
VO 73
IS 10
A1 Mohinder Sarna
A1 Stephen B Lambert
A1 Theo P Sloots
A1 David M Whiley
A1 Asma Alsaleh
A1 Lebogang Mhango
A1 Seweryn Bialasiewicz
A1 David Wang
A1 Michael D Nissen
A1 Keith Grimwood
A1 Robert S Ware
YR 2018
UL http://thorax.bmj.com/content/73/10/969.abstract
AB Introduction Viral acute respiratory infections (ARIs) cause substantial child morbidity. Sensitive molecular-based assays aid virus detection, but the clinical significance of positive tests remains uncertain as some viruses may be found in both acutely ill and healthy children. We describe disease-pathogen associations of respiratory viruses and quantify virus-specific attributable risk of ARIs in healthy children during the first 2 years of life.Methods One hundred fifty-eight term newborn babies in Brisbane, Australia, were recruited progressively into a longitudinal, community-based, birth cohort study conducted between September 2010 and October 2014. A daily tick-box diary captured predefined respiratory symptoms from birth until their second birthday. Weekly parent-collected nasal swabs were batch-tested for 17 respiratory viruses by PCR assays, allowing calculation of virus-specific attributable fractions in the exposed (AFE) to determine the proportion of virus-positive children whose ARI symptoms could be attributed to that particular virus.Results Of 8100 nasal swabs analysed, 2646 (32.7%) were virus-positive (275 virus codetections, 3.4%), with human rhinoviruses accounting for 2058/2646 (77.8%) positive swabs. Viruses were detected in 1154/1530 (75.4%) ARI episodes and in 984/4308 (22.8%) swabs from asymptomatic periods. Respiratory syncytial virus (AFE: 68% (95% CI 45% to 82%)) and human metapneumovirus (AFE: 69% (95% CI 43% to 83%)) were strongly associated with higher risk of lower respiratory symptoms.Discussion The strong association of respiratory syncytial virus and human metapneumovirus with ARIs and lower respiratory symptoms in young children managed within the community indicates successful development of vaccines against these two viruses should provide substantial health benefits.